An international Delphi consensus on patient preparation for metabolic and bariatric surgery

Congratulations! An international Delphi consensus on patient preparation for metabolic and bariatric surgery has been published in Clinical Obesity. This project was led by Andrew Robertson, Wah Yang, and Kamal Mahawar, with global experts in the field of obesity, metabolic and bariatric surgery and its multidisciplinary team, and Danielle Clyde as the first author. We look forward to collaborating with more global leaders and experts in the coming future.

Clinical Obesity

Abstract:

Global obesity rates have risen dramatically, now exceeding deaths from starvation. Metabolic and bariatric surgery (MBS), initially for severe obesity (BMI ≥35 kg/m2), is performed globally over 500 000 times annually, offering significant metabolic benefits beyond weight loss. However, varying eligibility criteria globally impact patient care and healthcare resources. Updated in 2022, ASMBS and IFSO guidelines aim to standardise MBS indications, reflecting current understanding and emphasising comprehensive preoperative assessments. Yet, clinical variability persists, necessitating consensus-based recommendations. This modified Delphi study engaged 45 global experts to establish consensus on perioperative management in MBS. Experts selected from bariatric societies possessed expertise in MBS and participated in a two-round Delphi protocol. Consensus was achieved on 90 of 169 statements (53.3%), encompassing multidisciplinary team composition, patient selection criteria, preoperative testing, and referral pathways. The agreement highlighted the critical role of comprehensive preoperative assessments and the integration of healthcare professionals in MBS. These findings offer essential insights to standardise perioperative practices and advocate for evidence-based guidelines in MBS globally. The study underscores the need for unified protocols to optimise outcomes and guide future research in MBS.

Keywords: Delphi; metabolic and bariatric surgery; perioperative.

Fulltext: https://onlinelibrary.wiley.com/doi/10.1111/cob.12722

Cite this paper:

Clyde DR, Adib R, Baig S, Bhasker AG, Byrne J, Cameron D, Catalain C, Clare K, de Beaux A, Drummond G, Fawal H, Fried M, Ghanem O, Graham Y, Goel R, Hopkins G, Husain F, Joyce B, Kermansaravi M, Kothari S, Kow L, Leite S, Madhok B, Mahon D, Miller K, Miras A, Moussa O, Neto MG, Nimeri A, O'Kane M, Parmar C, Peterli R, Poggi L, Saliminen P, Sarkar R, Shenfine J, Sogg S, Stenberg E, Suter M, Taha S, Tahrani A, Vilallonga R, Voon K, Welbourn R, Zerrweck C, Lamb P, Mahawar KK, Yang W, Robertson AGN. An international Delphi consensus on patient preparation for metabolic and bariatric surgery. Clin Obes. 2024 Dec 14:e12722. doi: 10.1111/cob.12722. Epub ahead of print. PMID: 39673462.